State prescription drug monitoring program hits a dead end

As many states move toward requiring health care providers to check prescription drug monitoring programs before dispensing controlled substances, Missouri is back at square one – again.

Missouri's legislative session ended May 13, at 6 p.m., leaving a bill that would have enacted a statewide prescription drug monitoring program to die in the Senate. It's the only state without such a program in place to reduce the potential for addiction, diversion and overutilization of powerful drugs.

Missouri Rep. Holly Rehder prefiled H.B. 1892 in December 2015. It's the fourth time the Republican has worked on the bipartisan bill, and she said it won't be the last.

It doesn't make sense that “we would sit back and say, 'We have the ability to have the tools to help with this, but we're not going to,' ” Rep. Rehder said. She added that prescription drug monitoring programs “help doctors recognize addiction on the front end” by showing whether a patient has recently visited the emergency room or another physician and any drugs he or she has been prescribed.

The opioid epidemic is personal for Rep. Rehder, whose 30-year-old daughter has struggled with prescription painkillers and other drugs since she was prescribed the narcotic Lorcet for a workplace injury 13 years ago.

“It has been very important to me to change the face of addiction and to show this is … in our home,” she said.

Opponents of the bill, including Missouri Sen. Rob Schaaf, also a Republican, argue that it raises privacy concerns because the database could be hacked. Sen. Schaaf, who is also a physician, has repeatedly filibustered attempts to enact a prescription drug monitoring program, Rep. Rehder said.

“We live in an electronic age,” she added. “If this was a privacy issue or a constitutional issue, certainly we would have seen it in these other states by now.”

In the meantime, Rep. Rehder said St. Louis County has passed an ordinance to implement its own database and that it hopes to involve nearby counties.

“We're going to work aggressively on these county databases and then come back again next year and try again,” she said.

Other states' efforts

Also last week, Arizona Gov. Doug Ducey signed S.B. 1283 into law. As a result, health care providers beginning in October 2017 must obtain patient utilization reports from the state's prescription drug database before prescribing a new course of Schedule II, III or IV controlled substances and at least quarterly.

“We are committed to ensuring that more substance abuse treatment options are available, and hope that those who are given a second chance at life because of this legislation will seek help in overcoming their addiction,” Gov. Ducey said in a statement.

More than 10 states, including New York, Massachusetts and Tennessee, now require health care providers to access databases before prescribing certain controlled substances.

Meanwhile, Pennsylvania's database is only available to the state's attorney general and law enforcement officials. It was expected to be made available to all health care providers and pharmacists in June 2015 as a result of the passage of S.B. 1180, but the process was delayed due to a lack of funds.

A spokesman for the state's Department of Health said Wednesday that the expansion is expected to take effect in August.

“Once the new (prescription drug monitoring program) is operational, by law, dispensers of monitored prescription drugs are required to collect and submit information to the (program) about each dispensing of a controlled substance prescription drug within 72 hours,” he said.